ICU气管插管患者非计划性拔管的临床特征分析及对策  

Characteristic of Unplanned Extubation of Patients with Tracheal Intubation in ICU

作　　者：毛丽洁[1] 郑秀云[1] 赵思思[1] 詹健[1] 肖兰香[1] 

机构地区：[1]温州医学院附属第一医院,浙江温州325000

出　　处：《护理学报》2011年第1期49-51,共3页Journal of Nursing（China）

摘　　要：目的分析ICU气管插管非计划性拔管(unplanned extubation,UEX)的临床特征,探讨有效预防护理对策。方法回顾性分析2008年4月—2010年6月各ICU科室共发生的34例非计划性拔管患者的资料。结果经口气管插管患者非计划性拔管构成比高于经鼻气管插管和气管切开患者,夜间非计划性拔管构成比高于白天,未镇静或镇静无效的患者容易发生非计划性拔管,气囊管理不规范易致非计划性拔管发生,本组34例计划性拔管患者中44%拔管后48 h内不需重新置管。结论尽量采取经鼻路径气管插管方式;合理安排护理人力资源,加强重点时段和重点患者监护;合理使用镇静剂,规范镇静评分;采取合适有效的约束方法;规范气囊管理可以降低ICU非计划性拔管的发生率。临床上对气管插管拔管指征可能偏于保守,对拔管指征应有更新更全面的掌握,减少患者置管时间。Objective To analyze the clinical characteristic of unplanned extubation（UEX） of tracheal intubated patient and provide preventive measures.Methods Retrospective analysis of 34 cases of UEX in ICU from April 2008 to June 2010 was made.Results There were many risk factors of UEX such as orotracheal intubation,at night,irregular use of sedative,irregular management of airbag,etc.Conclusion To reduce the incidence of UEX,nasal intubation,reasonable arrangement of human resources are recommended and the focus should go to strengthen care at priorities time,use sedative reasonable,standardize assessment of sedation,restrain patients effectively,standardize management of airbag and control indications of extubation.

关 键 词：ICU 气管插管 非计划性拔管 临床特征 护理 

分 类 号：R473.6[医药卫生—护理学]